Endoscopic-assisted adenoidectomy

Adenoidectomy is a commonly performed procedure. The advent of endoscopic sinus surgery has popularized the use of endoscopes. Endoscopic-assisted adenoidectomy (EAA) is a natural progression of this technology to allow a more complete adenoidectomy. Two hundred thirty-six patients undergoing adenoidectomy were evaluated with an endoscopic technique. A routine transoral adenoidectomy was performed first. Then a 4-mm 0 degrees telescope was used transnasally, and residual adenoid tissue was removed from the anterior superior nasopharynx. Invariably, residual adenoid tissue was found after transoral adenoidectomy. The EAA technique is minimally invasive, adds less than 5 minutes to the procedure, and is not associated with excessive bleeding. Readily available telescope and endoscopic equipment is used. The EAA technique is advocated for use as an adjunct to a more complete adenoidectomy.     

Correlates of sexual risk-taking among gay male substance abusers

This paper examines sexual risk-taking within a sample of sexually active gay and bisexual men entering substance abuse treatment (n= 383), and identifies correlates of unprotected anal sex within this group. Sexual risk-taking was high, with 55% of these men engaging in anal intercourse without a condom within a 90–day period. Correlates of unprotected anal sex varied somewhat when looking at unprotected anal sex with a primary partner only and with non-primary partners; substance use variables (number of drugs used, use of inhalant nitrites or stimulant drugs with sex, length of time since use of alcohol/drugs, loss of control problems associated with alcohol/drug use) appear to play more of a role in unprotected anal sex with non-primary partners. Overall, logistic regression analyses indicated that sexual risk was greater for those who were more sexually active, enjoyed unprotected anal sex with withdrawal prior to ejaculation, did not approve of sex outside of a love relationship, and identified themselves as more risky. In addition, those who reported more social problems due to substance use had fewer expectations that substance use increased risk, had been HIV-tested, and used reappraisal/problem-solving coping strategies showed greater risk with a primary partner only. Sexual risk with non-primary partners was greater for those who used more drugs, reported more difficulty avoiding high-risk sex when aroused and were HIV + The paper discusses the implications of these findings for the design of sexual risk-reduction interventions.     

THE IMPACT OF RESPONSE OPTIONS AND LOCATION IN A MICROCOMPUTER INTERVIEW ON DRINKING DRIVERS' ALCOHOL USE SELF-REPORTS

The influence of response options for and location of frequencyof alcohol use items in a self-administered microcomputer interviewwere evaluated in a randomized, experimental study of 296 clientsat a west coast treatment site for drinking drivers. Respondentswere asked about their frequency of alcohol use in the last7 days, 30 days, 90 days, and 180 days with three methodologicalfactors randomized (1) how quantitative tbs response optionswere; (2) order of presentation of close-ended response options;and (3) relative placement of alcohol use items in the questionnaire.Results indicate that these methodological factors had minimalinfluence on self-reports of the frequency of alcohol use. Onlytwo statistically significant effects out of 44 possible wereobserved. The findings of this study suggest that frequencyof alcohol use reports by drinking drivers yield similar informationfor a range of different response formats and location of theitems in a microcomputer interview.     

Pregnancy is associated with a reduction in the pattern of the cytotoxic activity displayed by lymphokine-activated killer cells.

Several modifications in the homeostasis of the maternal immune system have been implicated in the survival of the fetoplacental graft. We have investigated the adaptive response of the cytotoxic nonmajor histocompatibility complex (MHC)-restricted effector lymphocytes in pregnancy, and have found that the spontaneous lytic activity against both natural killer (NK)-sensitive and NK-resistant target cells is either decreased or lacking in peripheral blood mononuclear cells (PBMNC) from pregnant women. Recombinant interleukin-2 (rIL-2) normalizes the cytotoxic activity of PBMNC from pregnant women against NK-sensitive target cells in a dose- and time-dependent manner, without modification in the normal amounts of HNK-1+, CD16+ (Leu 11, or CD11b+ (OKM-1) present in these effector populations. However, the pattern of lytic activity against NK-resistant target cells found in PBMNC from pregnant women after short- and long-term incubation with rIL-2 was reduced in comparison with that observed in PBMNC from nongravid women in similar conditions. Moreover, rIL-2 incubation of PBMNC from pregnant subjects was not associated with an enhancement of the lytic binding against NK-resistant target cells. These findings demonstrate that pregnancy is not only associated with a reduction in the NK lytic activity of PBMNC, but also with a reduction in the generation of lymphokine-activated killer activity, in terms of the pattern of lytic activity developed.